Cosmetic Outcomes and Symmetry Comparison in Patients Undergoing Bilateral Therapeutic Mammoplasty for Breast Cancer

Abstract

Background Breast-reduction techniques are increasingly used in oncoplastic breast surgery. Bilateral therapeutic mammoplasty has the benefit of decreasing breast volume, enabling resection of larger tumors, and the potential to assure good postoperative symmetry. The aims of this study were to objectively asses the cosmetic outcomes of therapeutic mammoplasty in patients with breast cancer, using the breast cancer conservative treatment cosmetic results (BCCT.core) software, to compare this score with the surgeon’s score and the patient’s assessment, and to evaluate if other defined parameters have an impact on cosmetic outcomes. The secondary aim was to compare breast symmetry pre- and postoperatively. Materials and Methods We enrolled 146 consecutive patients with primary breast cancer who underwent therapeutic mammoplasty between 2011 and 2018 in Kristianstad Central Hospital, Sweden. We retrospectively collected data from patients’ records. We analyzed the BCCT.core score using postoperative photographs to objectively evaluate cosmetic outcomes on a four-grade scale and compared with preoperative photographs to evaluate symmetry. Cosmetic outcomes were also assessed subjectively by patients and surgeons, using a 10-point Likert scale. Results The majority of patients (89%) had good or excellent BCCT.core scores, which correlated with surgeons’ scores, rs = − 0.22 (p < 0.001). Overall, patients were more satisfied with the cosmetic outcomes than the surgeons (p < 0.001). Evidence supporting an association between the defined clinicopathological variables, for example, tumor size, and cosmetic outcomes, was weak. Conclusion Therapeutic mammoplasty yields a very good cosmetic outcome, evaluated both by subjective and objective measurements. Importantly, symmetry can be improved in patients with asymmetry.

Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

“…The mean excised breast volume in group I was 210g (range 100-300g) however, it was 105g (range 80-170g) in group II (p=<0.001). The patients and tumor characteristics are provided in Table (1). There was significant statistical difference in both group as regards the operative time, estimated blood loss and postoperative complications.…”

“…BREAST-CONSERVING surgery (BCS) has been proven to achieve excellent oncologic results and became the standard surgical treatment for breast cancer in early stages. Successful BCS depends on resecting the tumor with clear margins followed by post-operative radiation therapy coupled with accepted cosmetic outcome [1] .…”

“…In conventional BCS, approximately 5%-18% of cases had positive margins, which led to high re-excision rates. This can be explained by surgeons trying not to excise too much breast tissue to achieve better cosmesis [1,2] . Oncoplastic breast surgery (OPBS) was first introduced more than 20 years ago, aiming atachieving both oncological safety and better cosmetic results, and studies have proved that oncological safety regarding local recurrence and survival are comparable to rates after conventional CBS [3] .…”

Comparing oncoplastic breast reduction with immediate symmetry surgery to standard breast reduction surgery: Are postoperative complications worse?

“…ORM is an accepted breast cancer surgical technique supported by varying breast cancer surgical societies and the National Comprehensive Cancer Network guidelines 1,10 . The ability to improve cosmesis and symmetry before radiation, combined with better surgical access to large tumors enabling wider margins has led to a wide acceptance of ORM among patients and surgeons alike 9,11 . A small number of previous studies have examined the potential complications of performing an ORM compared to the well‐documented standard reduction mammoplasty (SRM) for benign symptomatic macromastia 7,12,13 .…”

“…1,10 The ability to improve cosmesis and symmetry before radiation, combined with better surgical access to large tumors enabling wider margins has led to a wide acceptance of ORM among patients and surgeons alike. 9,11 A small number of previous studies have examined the potential complications of performing an ORM compared to the well-documented standard reduction mammoplasty (SRM) for benign symptomatic macromastia. 7,12,13 However, further research is needed to better understand the safety profile of ORM.…”